Prescription Drug Coverage
Prescription drug coverage is included in the Blue Care Network HMO plan. Each prescription or refill requires a copayment of just $10 for generic drugs or $40 for brand name drugs, or 50%, whichever is less.
Blue Care Network does not approve coverage for:
- Contraceptives.
- Cosmetic drugs or drugs used for cosmetic purposes.
- Drugs that are not FDA approved or are being used for experimental or investigational purposes.
- Prescriptions filled after you are no longer a member.
- Drugs included as a health care benefit, such as vaccines and other injectable drugs that are normally administered in a physician's office.
- Drugs included as a benefit under Medicare or under any other health care program funded by federal or state government.
- New drugs not yet added to the formulary.
- Replacement prescriptions resulting from loss, theft or mishandling.
- Drugs included in the cost of other services or supplies.
- Drugs for which there are over-the-counter equivalents in both strength and dosage. (Note: BCN covers OTC Claritin (generic) and Prilosec OTC for the lowest copayment with a prescription from your doctor. These are listed in the formulary.)
- Durable medical equipment and supplies, such as inhaler spacer devices and blood glucose monitors.
Mail order prescriptions
For prescriptions you take on a regular basis, consider using our mail order plan that comes with the prescription drug coverage. Purchase up to a 90-day supply of your prescription for a $10 copay for generic drugs or $40 for brand name drugs for each 90-day prescription or refill.
